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医护人员为何对结核病感到厌烦。

Why healthcare workers are sick of TB.

作者信息

von Delft Arne, Dramowski Angela, Khosa Celso, Kotze Koot, Lederer Philip, Mosidi Thato, Peters Jurgens A, Smith Jonathan, van der Westhuizen Helene-Mari, von Delft Dalene, Willems Bart, Bates Matthew, Craig Gill, Maeurer Markus, Marais Ben J, Mwaba Peter, Nunes Elizabete A, Nyirenda Thomas, Oliver Matt, Zumla Alimuddin

机构信息

TB Proof; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, 7925, South Africa.

TB Proof; Paediatric Infectious Diseases, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.

出版信息

Int J Infect Dis. 2015 Mar;32:147-51. doi: 10.1016/j.ijid.2014.12.003.

Abstract

Dr Thato Mosidi never expected to be diagnosed with tuberculosis (TB), despite widely prevalent exposure and very limited infection control measures. The life-threatening diagnosis of primary extensively drug-resistant TB (XDR-TB) came as an even greater shock. The inconvenient truth is that, rather than being protected, Dr Mosidi and thousands of her healthcare colleagues are at an increased risk of TB and especially drug-resistant TB. In this viewpoint paper we debunk the widely held false belief that healthcare workers are somehow immune to TB disease (TB-proof) and explore some of the key factors contributing to the pervasive stigmatization and subsequent non-disclosure of occupational TB. Our front-line workers are some of the first to suffer the consequences of a progressively more resistant and fatal TB epidemic, and urgent interventions are needed to ensure the safety and continued availability of these precious healthcare resources. These include the rapid development and scale-up of improved diagnostic and treatment options, strengthened infection control measures, and focused interventions to tackle stigma and discrimination in all its forms. We call our colleagues to action to protect themselves and those they care for.

摘要

塔托·莫西迪医生从未料到自己会被诊断出患有结核病(TB),尽管接触结核病的情况非常普遍,且感染控制措施极为有限。原发性广泛耐药结核病(XDR-TB)这一危及生命的诊断结果更是让人大吃一惊。不便的事实是,莫西迪医生和她的数千名医护同事非但没有得到保护,反而感染结核病尤其是耐药结核病的风险增加了。在这篇观点文章中,我们揭穿了一个广泛存在的错误观念,即医护人员对结核病具有某种免疫力(防结核病),并探讨了导致职业性结核病普遍受到污名化以及随后不被披露的一些关键因素。我们的一线工作人员是最早遭受日益耐药且致命的结核病疫情后果的人群之一,需要采取紧急干预措施,以确保这些宝贵的医疗资源的安全并使其持续可用。这些措施包括迅速开发和扩大改进的诊断和治疗方案、加强感染控制措施,以及采取针对性干预措施来消除各种形式的污名化和歧视。我们呼吁同事们行动起来,保护自己以及他们所照顾的人。

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